Your healthcare provider may find signs of vulvar cancer during a pelvic exam as part of a routine visit. You may not have any symptoms. A Pap test and a human papillomavirus (HPV) test will likely be done. Diagnosing vulvar cancer starts with your healthcare provider asking you questions. You'll be asked about your health history, symptoms, risk factors, and family history of disease.

It’s very important that you see an expert. Gynecologic oncologists are specialists in diagnosing, treating, and checking for female cancers, including vulvar cancer. Your healthcare provider may have you see one of these cancer experts to find out for sure what’s causing the changes in your vulva. If this provider thinks you might have vulvar cancer, you’ll need a biopsy to be sure.

A biopsy is the only way to know for sure if you have cancer. If your healthcare provider sees an abnormal or changed area, you may need a biopsy. A biopsy is done by removing a small piece of tissue from that area. Medicines may be used to make your vulva numb first. If the abnormal area is small, your healthcare provider may completely remove it. If it's big, he or she can remove a small piece of it by using a tool that looks like a tiny apple corer. (This is called a punch biopsy.) You often don’t need stitches after this procedure. You may feel some pressure, but should have little or no pain.

For larger areas, your healthcare provider may cut out a small part of the skin with a scalpel. The edges of your skin may then be sewed together with surgical thread (suture). In most cases, your healthcare provider will also remove some surrounding normal skin along with the abnormal area.

Your healthcare provider may use a magnifying tool called a colposcope to get a close look at the changed area. The colposcope stays outside your body. It lets your provider see even small changes on your vulva. Your provider may put a vinegar-like solution on your vulva to make the changed areas white. This makes them easier to see and remove.

The removed tissue sample is sent to a lab. There, a doctor called a pathologist checks the samples under a microscope to look for cancer cells. It often takes about one week for your healthcare provider to get the results from the lab.

When your healthcare provider has your biopsy results, he or she will contact you. Your provider will talk with you about other tests you may need if vulvar cancer is found. Make sure you understand the results and know what you need to do next.